While some called it a “dirty hit,” others were quick to write it off as an unfortunate football injury typical of a heated rivalry.

Smith-Schuster was flagged for unnecessary roughness after his blindside block for Le’Veon Bell sent Burfict to the ground with 7:10 left to play. Smith-Schuster then stood over Burfict, which drew a taunting penalty that was declined, and Burfict missed the remainder of the game with a head injury after getting carted off the field.

“That was a dirty hit,” Bengals receiver A.J. Green said. “It was not called for. We already are playing a dangerous sport. We all put our lives on the line when we come here every week, and you don’t want something like that happening to a player, no matter what team we’re playing, no matter how big the rivalry is. We have to protect each other.”

The rivalry seems to intensify things in this matchup, though. Burfict was one of three Bengals players in concussion protocol after the game, as Joe Mixon and Dre Kirkpatrick also joined him, and Burfict was one of two players carted off the field.

Steelers linebacker Ryan Shazier suffered a back injurywhile leading head first on a tackle in the first quarter and taken to the hospital. According to a statement from Pittsburgh general manager and vice president Kevin Colbert, Shazier will remain at the University of Cincinnati Medical Center overnight but will not require surgery.

Mixon was injured on a helmet-to-helmet tackle by Vince Williams that at first appeared to knock the Bengals’ running back out. He popped up after a few minutes on the ground with trainers and walked off on his own. Kirkpatrick was in the game until the last play but later reported concussion-like symptoms.

“I feel like some guys get caught in weird positions,” linebacker Kevin Minter said. “It wasn’t necessarily more hard-hitting than any other game. It’s just awkward tackles. Shazier, it looked like his neck and head were too far over on the tackle, and it went all the way down his back or something. With Tez, he was getting caught off guard. It’s the game. It is what it is. I’m praying for Shazier and praying for Tez and hope everything works out, but at the end of the day it’s football.”

Burfict, who also has caused injuries to Pittsburgh players in the past, wasn’t noticeably moving while on the ground after Smith-Schuster’s hit but signaled to fans with his hand while being carted off. Burfict walked into the Bengals locker room, according to media reports.

“If that was Tez they would have kicked him out,” cornerback Will Jackson III said of Smith-Schuster’s hit. “They should have kicked him out. It was a dirty hit.”

Safety George Iloka said the injuries are part of the rivalry and nothing new to the series.

“They threw the flag, so the refs did what they had to do, but the hit, I don’t feel no way about it, good or bad,” he said. “It’s a football kind of thing. It’s dangerous, but it is a football thing. The standing over him, someone is hurt, there’s no need for that. … This whole game has been chippy so that’s just one of many incidents on both sides.”

Iloka was flagged for a unnecessary roughness for a hit on Steelers receiver Antonio Brown. Brown hung onto the ball after the helmet-to-helmet hit for a tying touchdown.

Neither head coach would specifically comment on the physicality or injuries, but Tomlin said Smith-Schuster should not have stood over Burfict after injuring him. Smith-Schuster apologized on Twitter after the game.

I don’t have any intentions to hurt anyone when I play football. I didn’t mean to hurt Vontez Burfict, I just wanted to throw a block for my teammate. I apologize for standing over him and that isn’t me. Praying he gets better.

“I don’t have any intentions to hurt anyone when I play football,” he wrote. “I didn’t mean to hurt Vontez (sic) Burfict, I just wanted to throw a block for my teammate. I apologize for standing over him and that isn’t me. Praying he gets better.”

Bengals running back Gio Bernard said the injuries are just “proof of how physical it is” between the Steelers and Bengals.

Seeing Shazier go down brought back memories of the 2015 playoff game when Shazier knocked Bernard out cold while also leading with the head. Bernard fumbled before he hit the ground, resulting in a turnover that stalled a promising Bengals drive late in their eventual 18-16 loss.

“Of course I thought back to when I wasn’t right, but that’s just football,” Bernard said. “That’s part of it. I was standing right there hoping he got up. Obviously, I’m praying for him. It’s tough to see a good player like that down, even when our guys went down, Joe and Vontaze.”

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